Athena Well being Care Techniques, one of many largest long-term care suppliers in Connecticut, has come below the scrutiny of officers in three New England states after receiving constant complaints about circumstances in its nursing properties.
Athena can also be dealing with a number of lawsuits alleging that the corporate didn’t pay worker well being advantages and that it didn’t pay for short-term staffing throughout the pandemic.
The Farmington, Conn.-based firm lately agreed to pay a $1.75 million high-quality to the Massachusetts Lawyer Common’s workplace — the most important nursing house high-quality ever in that state — for admitting individuals with substance abuse points to its nursing properties with out having the ability to present them with applicable remedy, resulting in “quite a few overdoses,” based on the Lawyer Common’s workplace.
And it’s dealing with a wrongful demise lawsuit from the household of a resident who died in a Massachusetts nursing house after being bludgeoned by his roommate with a walker.
The corporate operates greater than 40 long-term care services in Connecticut, Massachusetts and Rhode Island. In Connecticut, it operates 21 services from Middletown to Sharon and serves greater than 2,500 residents.
We’ve got had ongoing, important considerations associated to this chain.
Lengthy Time period Care Ombudsman Mairead Painter
Athena’s struggles spotlight points dealing with many nursing house operators — an absence of workers making it tough to fulfill minimal hourly necessities, monetary hardship partially brought on by inflation, and a smaller pool of residents years into the pandemic.
The Connecticut Mirror reviewed a number of lawsuits in opposition to Athena and consent orders issued by public well being companies in Connecticut, Massachusetts and Rhode Island, together with police experiences.
The paperwork present:
- Six short-term employment companies have filed lawsuits in opposition to Athena in Connecticut, alleging that the corporate has didn’t pay them greater than $142,000 for workers they offered since 2021 to offset workers shortages.
- One other lawsuit claims Athena owes practically $2 million for short-term employees offered by a separate firm.
- An Iowa-based insurance coverage firm has filed a federal lawsuit alleging that Athena, a self-insured firm, has didn’t pay greater than $6 million in medical health insurance claims from its workers, a difficulty that prompted state officers to contact the U.S. Division of Labor to research.
- A consent order at Athena’s Middlesex Well being Care Heart in Connecticut required it to rent an impartial nurse advisor to overview and revise assessments of staffing ranges and medicine administration and monitor the frequency of mattress sores.
- Three consent orders had been issued by the Massachusetts Division of Public Well being for affected person issues of safety and staffing shortages, and Rhode Island officers issued a consent order after investigators found unsanitary circumstances, reminiscent of individuals consuming on Styrofoam plates for six months as a result of there was no dishwasher.
- A wrongful demise lawsuit was filed in Massachusetts by the property of Robert Boucher, who was a resident on the Oxford Rehabilitation and Well being Care Heart in Haverhill when, in October 2019, his roommate beat him within the head repeatedly with a walker earlier than workers intervened. Boucher died from his accidents.
From October 1, 2021 to Sept. 30, 2022, Connecticut’s Lengthy Time period Care Ombudsman’s workplace obtained 518 complaints about circumstances in Athena nursing properties, together with the Middletown facility — a big improve from earlier years, officers stated.
“We’ve got had ongoing, important considerations associated to this chain,” Lengthy Time period Care Ombudsman Mairead Painter informed the CT Mirror. “We’ve got reported them to different state companies as a result of stage of concern and the variety of complaints we’re getting, particularly, associated to staffing.”
The Division of Public Well being licenses nursing properties and conducts inspections of the services that take part in Medicare or Medicaid about every year on common. State officers might examine a house extra incessantly whether it is “low-performing,” based on DPH. Medicaid covers greater than 70% of nursing house residents in Connecticut.
The state additionally investigates complaints from households, residents and Painter’s workplace associated to nursing house care.
Throughout a nursing house inspection, a group sometimes observes resident care processes and workers interplay with residents and opinions scientific and medicine information.
Nursing properties in Connecticut are required to supply at the least three hours of direct care per resident per day. The legislature voted to lift the minimal care requirement from 1.9 hours to a few in 2021.
As a result of Athena additionally owns and operates expert nursing services in Rhode Island and Massachusetts, DPH and DSS have met with counterparts in these states to usually talk about Athena operations.
CHRISTOPHER BOYLE, CT Division of Public Well being spokesman
The Division of Public Well being has at the least twice lately shut down long-term care services when officers believed resident security or care was in jeopardy. However state officers have stated beforehand they’re reluctant to take such a drastic step as a result of they have to discover new properties for residents.
Whereas DPH officers stated they’re monitoring Athena’s services intently, there are not any plans to shut any of them. The one facility presently overseen by an impartial advisor is Middlesex Well being Care.
Connecticut Division of Public Well being spokesman Christopher Boyle stated that DPH and the state Division of Social Companies, which oversees the monetary aspect of nursing properties, are conscious that Athena has been experiencing monetary challenges.
Boyle stated DPH officers “have been monitoring the corporate’s monetary standing as a part of an total effort to proactively determine potential impacts on resident care.”
“As a result of Athena additionally owns and operates expert nursing services in Rhode Island and Massachusetts, DPH and DSS have met with counterparts in these states to usually talk about Athena operations, as firm experiences in anybody state might impression operations and resident care within the different states,” Boyle added.
Unprecedented challenges and bills and the ensuing extreme staffing shortages have resulted in considerably greater bills and have put a pressure on sources.
Lawrence Santilli, proprietor of Athena Well being Care Techniques
In response to a collection of questions from the CT Mirror, Athena’s proprietor, Lawrence Santilli, acknowledged the corporate has had monetary difficulties which have “undermined the standard of care” in some services.
“For Athena, which serves 1000’s of sufferers each day throughout its 45 services with 1000’s of workers, these unprecedented challenges and bills and the ensuing extreme staffing shortages have resulted in considerably greater bills and have put a pressure on sources,” Santilli stated in an emailed assertion.
“To satisfy the discharge wants of the state’s hospital system and present residents, Athena was compelled to resort to utilizing short-term nursing staffing companies on the highest ranges and the very best prices ever skilled by the corporate, and at instances undermining the standard and consistency of care that has all the time been our aim.”
Santilli stated Athena was a “pioneer” when it got here to helping the state throughout COVID. The corporate opened COVID restoration services in Meriden and Torrington and took others into nursing properties in Bridgeport and Sharon. Athena was hailed by Gov. Ned Lamont on the time as a key a part of liberating up hospital beds and serving to curb the unfold of the virus in nursing properties.
‘We really feel so helpless’
Patty Bausch, 62, has lived on the Newtown Rehabilitation and Well being Care Heart for 4 years. However lately, staffing issues have meant she has needed to wait hours to be modified — an uncomfortable ordeal for somebody who’s susceptible to urinary tract infections.
“Generally it’s important to wait two, perhaps three hours to have your transient modified,” Bausch stated in a current interview. “You’re sitting in a moist transient for that period of time. It’s horrible. We simply really feel so helpless.”
Painter, the ombudsman, is worried in regards to the mounting complaints from households and residents, whether or not it’s somebody caught in mattress, medicines not being distributed or meals being missed.
Painter stated the 518 complaints her workplace has obtained since September 2021 is “doubtless an undercount” and extra go unreported. In some instances, a resident might name to report a difficulty after which change their thoughts for worry of retribution. Different instances, when her workplace goes to interview somebody, different residents might chime in with related considerations, however it’s nonetheless recorded as a single criticism.
The Athena services that obtained essentially the most complaints are the Middlesex Well being Care Heart in Middletown, Newtown Rehabilitation & Well being Care Heart in Newtown, Valerie Manor in Torrington, Abbott Terrace Well being Heart in Waterbury and Bayview Well being Care in Waterford, Painter stated.
In some Athena properties, residents reported seeing 20 residents assigned to 1 licensed nursing aide. A typical ratio to make sure residents are receiving excellent care is one employee to each eight or 10 residents, relying on the wants of residents, Painter stated.
The commonest criticism is lack of entry to care, sometimes stemming from understaffing, she stated. That may imply a resident is left ready a very long time with out help to go to the lavatory or is left in mattress when the particular person as an alternative needs to rise up for the day.
Bausch stated the shortage of workers is noticeable. When she first arrived on the facility, she would bathe with the assistance of nursing aides a number of instances per week.
“Now I’m fortunate if I get one,” she stated.
Meals arrive late and chilly, Bausch stated. Every day actions are missed if workers are usually not accessible to assist her get away from bed and into her wheelchair.
In Could, relations had organized to throw a birthday celebration for Bausch’s son on the nursing house so Bausch may very well be a part of the celebration. However workers weren’t accessible to assist her away from bed, she stated, and he or she missed the occasion.
“Due to COVID, I’ve needed to miss occasions like that. So at some point, they had been going to return to the power and convey the occasion to me, which I used to be so enthusiastic about,” Bausch stated. “However that specific day, there was no assist and there was one aide, she stated, ‘I’m sorry, you’re not getting up for that. I can’t do it.’”
Painter’s workplace additionally incessantly hears about environmental considerations, reminiscent of trash not being emptied or issues with heating or air-con, and points with meals, like poor high quality meals, residents not receiving meals in a well timed method and an absence of dietary help.
Athena has launched an “ambassador program” in its Connecticut services to “deal with customer support, communication and most significantly, function an advocate to the residents,” Savannah Ragali, director of selling and communications for Athena, wrote in an electronic mail to the CT Mirror. “A part of their obligations is to make sure that residents’ considerations are dropped at the suitable division for fast and well timed decision. Newtown Rehabilitation and Well being Care Heart has an envoy at their heart.”
‘So heartbreaking’
DPH’s investigators made a number of unannounced visits to the Middlesex Well being Care Heart from November 2021 by way of April 2022, and what they uncovered led them to order Athena to rent an impartial nursing advisor to supervise the power.
Athena employed Tami Reilly, a registered nurse, over the summer time. She is required to submit periodic experiences to DPH for at the least six months, based on the consent order.
Considered one of Reilly’s preliminary experiences obtained by the CT Mirror particulars the extent of the staffing scarcity on the facility. In July, the house was with out an administrator, an assistant director of nursing and a meals service director, and the shortage of shift supervisors was so extreme that it compelled the nursing director to work greater than 68 hours per week filling in shifts, Reilly stated in her August 2022 report.
We’re assured that we’re on the suitable path and don’t have any plans to promote or shut any Athena services.
Lawrence Santilli, Proprietor of Athena Well being Care Techniques
The report outlines a variety of points that officers say can occur when a facility is short-staffed: an open bag of potato chips was discovered subsequent to a urinal tray on a resident’s evening stand; residents had waste-stained sheets as a result of they had been left in mattress for hours; a resident with a “choking hazard designation” was left with alone with a plate of meals till Reilly known as in workers after the particular person had eaten half of a sandwich.
It additionally describes the overall lack of maintenance on the facility, with rust stains on lavatory vanities, soiled, dingy flooring in want of a waxing, damaged closets, and 16 of the 18 personalized wheelchairs on the house discovered of compliance.
Santilli stated Athena voluntarily agreed to the impartial nurse association and halted new admissions.
“We took a proactive strategy … [deciding] to not settle for new admissions right now and deal with making certain the protection and top quality of look after our residents and workers,” he stated.
“As a long-time chief within the Connecticut nursing house trade with over 38 years of expertise, and dealing in cooperation with related state companies, we’re assured that we’re on the suitable path and don’t have any plans to promote or shut any Athena services.”
For Painter, the impartial nurse’s experiences affirm the complaints they’ve been getting at a number of Athena properties.
“Each story is so heartbreaking to listen to,” Painter stated. “What’s laborious is that the complaints typically fall on the particular person giving the care that day, the CNA or the nurse, and people persons are there as a result of they haven’t given up.
“The place we aren’t seeing accountability and the individuals exhibiting up is within the possession and company.”
Monetary troubles in Connecticut
In Connecticut, information present there are six lawsuits pending in opposition to Athena filed by short-term employment companies, together with one filed this summer time by Care Given At House LLC. All informed, the businesses allege that Athena has didn’t pay them greater than $142,000 for offering short-term nurses and nurses’ assistants to fill in at services that had been short-staffed. The follow of hiring short-term employment companies is frequent for suppliers, particularly because the pandemic hit and workers have stop.
All the lawsuits have been filed since July, with a number of filed late in December, after the announcement of the high-quality in Massachusetts. All the instances are nonetheless pending.
Boyle stated the DPH was conscious of 1 criticism from a short lived staffing company that stated it was owed cash by Athena and couldn’t proceed to supply providers with out getting paid.
[New workers] are available they usually’re overwhelmed … It’s like quicksand in right here.
Patty Bausch, resident, Newtown Rehabilitation and Well being Care Heart
Athena is also dealing with a federal lawsuit in Iowa from ClaimDOC LLC, an organization that was overseeing its self-insured program for workers. The lawsuit alleges that Athena in 2021 and 2022 didn’t pay greater than $6 million in well being care claims filed by its workers in addition to greater than $2 million in charges to ClaimDOC.
Boyle stated the state has obtained complaints from former and present Athena workers about medical health insurance points, however DPH doesn’t have any jurisdiction over them.
“Each companies [DPH and DSS] referred the complaints regarding Athena’s failure to pay worker medical health insurance claims to the Area 1 places of work of the U.S. Division of Labor, Worker Advantages Safety Administration, which has jurisdiction over self-insured well being plans coated by ERISA, and each companies have likewise conveyed these critical considerations on to the U.S. Division of Labor,” Boyle stated.
Santilli stated the corporate has been working to settle the lawsuits introduced by the short-term companies and is in touch with the Division of Labor in regards to the medical health insurance claims.
“We’ve got come to agreements with the short-term staffing companies to resolve past-due quantities and have labored diligently on rebuilding our workforce,” Santilli stated. “We’ve got additionally made important funds towards medical health insurance claims and anticipate to be in compliance by the tip of the month. At present, Athena is working cooperatively with the DOL.”
For Bausch, the frequent workers turnover has made it tough not solely to get care but in addition to kind relationships with the employees she depends on daily.
“They arrive in they usually’re overwhelmed,” she stated. “It’s like quicksand in right here.”
Directors who’ve pledged to bolster staffing have additionally left.
“We maintain listening to that they’re hiring individuals, however the individuals who saved telling us which might be [now] gone,” Bausch stated. “Lots of administration has left.”
“All people right here feels the ache” of the nursing aides, she stated. “We all know it’s laborious work. It’s not a straightforward job. However when the residents are made to really feel responsible that there’s not sufficient workers right here — it’s not good.”
Largest high-quality ever
In late December, a few of Athena’s points turned public when then-Massachusetts Lawyer Common Maura Healey introduced that Athena had agreed to pay a $1.75 million high-quality.
In a press launch, Healey stated the settlement resolved a long-running investigation into a number of allegations, together with that Athena “failed to fulfill the wants of nursing house residents experiencing substance abuse dysfunction.”
She known as it the most important settlement with a nursing house in state historical past. Athena operates 18 nursing properties in Massachusetts.
The investigation confirmed that Athena admitted numerous residents with a historical past of substance abuse, regardless of not having the services or workers educated to look after them. The investigation uncovered quite a few overdoses, a few of which Athena didn’t report back to the Massachusetts Division of Public Well being as required by legislation. The legal professional common’s workplace didn’t reveal what number of overdoses there have been or how many individuals died.
“This decision ensures that Athena services will appropriately present care for people with substance use dysfunction and helps to revive the belief households want when making essential selections in regards to the care of their family members,” stated Healey, who’s now governor.
Whereas the legal professional common’s workplace was conducting that investigation, the Massachusetts Division of Public Well being was additionally probing a number of of the identical services for a wide range of allegations, together with not having sufficient workers and failure to comply with COVID protocols at a Plymouth, Mass., facility that led to a widespread outbreak, information present.
The COVID outbreak on the Plymouth Rehabilitation and Well being Care Heart was so dire that the well being division suspended Athena’s license to function the power in November 2021.
The discover stated {that a} lack of staffing and the power’s incapability to cut back the variety of rooms with three residents posed an “imminent well being menace.”
The suspension was lifted in February 2022, based on Massachusetts DPH spokesman Omar Cabrera.
Two different Athena properties had been designated as “particular focus services” as a result of that they had poor compliance historical past over a three-year interval — Marlborough Hills Rehab and Well being Heart and Oxford Rehabilitation and Well being Care Heart in Haverhill, Mass. The designation required the services bear a survey each six months till they handed all well being and security rules.
Marlborough Hills remains to be below the order issued in November 2021, Cabrera stated.
Oxford, which was designated an SFF in November 2019, “graduated” from the particular focus facility program in October 2021, Cabrera stated.
Needed to kill him
The Oxford facility got here below state overview due to a murder.
Shortly after 7:30 p.m. on Oct. 6, 2019, nurse Maria Sanchez was delivering remedy to residents when she heard noises coming from room 216, based on police experiences. When she entered the room, she noticed a resident, Jose Veguilla, holding his walker over the mattress of his roommate, Robert Boucher.
Boucher was bleeding profusely from a head wound, and as Sanchez rushed to cease Veguilla, he threatened to hit her with the bloody walker as properly. She rushed out of the room to get assist, but it surely was too late for Boucher, a person who suffered from extreme despair as a result of his decrease proper leg had lately been amputated.
When a second workers member, nursing aide Diane Flores, entered the room and tried to talk with Veguilla in Spanish, he informed her he “needed to kill Boucher.”
When the primary police officer arrived, Veguilla was on the entrance to the power’s day room, swinging his walker wildly at workers members. He dropped it when the officers approached him, the police report states.
Boucher died on the hospital of his head accidents, and Haverhill police charged Veguilla with homicide. He was finally discovered incompetent to face trial and dedicated to the Bridgewater State Psychological Hospital.
The DPH investigation of the murder finally led to a $15,895 high-quality of Athena by the Facilities for Medicare & Medicaid Companies, the federal company that oversees long-term care services.
However Athena’s issues from that murder are usually not over.
Boucher’s representatives filed a wrongful demise lawsuit in opposition to Athena final August, in search of financial damages for the power’s failure to guard Boucher from his roommate, who had a “demonstrated historical past of violent conduct towards sufferers and workers.”
The lawsuit alleges that Athena didn’t heed complaints by Boucher that he “was afraid of Veguilla” and didn’t develop a complete care plan for him. Veguilla suffers from dementia and had made threats of violence in opposition to a number of workers members within the seven months Boucher had been on the Oxford facility, the lawsuit states.
The case is pending at Middlesex Superior Courtroom. As a result of the lawsuit is ongoing, Santilli stated, he couldn’t touch upon it.
